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孕前体重指数与新鲜/冷冻胚胎移植对辅助生殖技术单胎妊娠围产结局的影响:一项回顾性队列研究。

Effect of the Interaction Between Pre-pregnancy Body Mass Index and Fresh/Frozen Embryo Transfer on Perinatal Outcomes of Assisted Reproductive Technology-Conceived Singletons: A Retrospective Cohort Study.

机构信息

Translational Medicine Center, Northwest Women's and Children's Hospital, Xi'an, China.

Departments of Pediatrics and Neonatology, Children's Hospital of Fudan University, Shanghai, China.

出版信息

Front Endocrinol (Lausanne). 2020 Sep 25;11:560103. doi: 10.3389/fendo.2020.560103. eCollection 2020.

Abstract

To demonstrate the association between pre-pregnancy maternal overweight, obesity, and perinatal outcomes of singletons conceived by assisted reproductive technology (ART). Retrospective cohort study from 2006 to 2015 data from a single ART center. Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, Northwestern China. We included 7,818 women undergoing ART and their singleton infants. None. The primary outcome measures were preterm birth (PTB), macrosomia, low birth weight, small for gestational age, and large for gestational age (LGA). We experienced an increase in the risk of PTB, macrosomia, and LGA in overweight and obese groups compared with that in normal-weight groups [PTB: overweight vs. normal weight: odds ratio [OR] = 1.44, 95% CI: 1.18-1.75; obesity vs. normal weight: OR = 1.53, 95% CI: 1.04-2.25; macrosomia: overweight vs. normal weight: OR = 1.78, 95% CI: 1.48-2.14; obesity vs. normal weight: OR = 2.16, 95% CI: 1.52-3.06; LGA: overweight vs. normal weight: OR = 1.63, 95% CI: 1.39-1.90; obesity vs. normal weight: OR = 2.11, 95% CI: 1.57-2.83]. We observed a significant interaction between maternal BMI and fresh/frozen embryo transfer on PTB and LGA ( = 0.030; = 0.030). Fresh embryo transfer significantly increased the effect of maternal BMI on LGA (fresh: OR = 1.14, 95% CI: 1.10-1.18; frozen: OR = 1.09, 95% CI: 1.04-1.13), and frozen embryo transfer increased the effect of maternal BMI on PTB (fresh: OR = 1.03, 95% CI: 0.99-1.08; frozen: OR = 1.09, 95% CI: 1.04-1.15). Pre-pregnancy maternal overweight and obesity were associated with higher risks of PTB, macrosomia, and LGA in ART-conceived singletons. These associations were affected by the timing of embryo transfer (fresh/frozen embryo transfer). Therefore, we recommend women before ART to maintain a normal BMI for the prevention of adverse perinatal outcomes.

摘要

为了证明辅助生殖技术(ART)受孕的单胎妊娠母亲超重、肥胖与围产期结局之间的关联。这是一项来自 2006 年至 2015 年单中心 ART 数据的回顾性队列研究。研究地点为中国西北妇女儿童医院辅助生殖中心。我们纳入了 7818 名接受 ART 并分娩单胎的妇女及其婴儿。无。主要结局指标为早产(PTB)、巨大儿、低出生体重、小于胎龄儿和大于胎龄儿(LGA)。与正常体重组相比,超重和肥胖组发生 PTB、巨大儿和 LGA 的风险增加[PTB:超重与正常体重:比值比(OR)=1.44,95%置信区间(CI):1.18-1.75;肥胖与正常体重:OR=1.53,95%CI:1.04-2.25;巨大儿:超重与正常体重:OR=1.78,95%CI:1.48-2.14;肥胖与正常体重:OR=2.16,95%CI:1.52-3.06;LGA:超重与正常体重:OR=1.63,95%CI:1.39-1.90;肥胖与正常体重:OR=2.11,95%CI:1.57-2.83]。我们观察到母亲 BMI 与新鲜/冷冻胚胎移植对 PTB 和 LGA 的交互作用有显著意义(=0.030;=0.030)。新鲜胚胎移植显著增加了母亲 BMI 对 LGA 的影响(新鲜:OR=1.14,95%CI:1.10-1.18;冷冻:OR=1.09,95%CI:1.04-1.13),而冷冻胚胎移植增加了母亲 BMI 对 PTB 的影响(新鲜:OR=1.03,95%CI:0.99-1.08;冷冻:OR=1.09,95%CI:1.04-1.15)。辅助生殖技术受孕的母亲孕前超重和肥胖与 PTB、巨大儿和 LGA 的风险增加相关。这些关联受胚胎移植时机(新鲜/冷冻胚胎移植)的影响。因此,我们建议妇女在接受 ART 前保持正常 BMI,以预防不良围产期结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7679/7546789/adfcba337731/fendo-11-560103-g0001.jpg

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